New here but same story....

Your story is almost identical to my darling wife's story. Her screen name here is A5, she has DDD, foraminal stenosis, Osteo, Fibro, "the list is endless", to borrow a phrase. I have severe pain caused by the life extending hormone therapy that is keeping my terminal cancer at bay. When I saw that you had asked your Dr. about Fentora I had to wonder if you were aware of it's stratospheric price. I was finally approved for it by my Health Insurance Co. (HIC) 2 weeks ago after a 6-7 week screening process . . . and this is for someone with terminal cancer, mind you, supposedly that's pretty much at the top of the priority heap as far as I know. Anyway, I was shocked at the uninsured price, $1,980 for #120 100 mcg at Save-On Drugs here in the Southwest. Luckily, my HI copay peaks at $250 which is what I have to pay monthly for each 4 p/d Rx.

That having been said, it is the best BTP med I have tried in the 32 months since I began treatment. It's a small, 3/16" diameter effervescent tablet that you place between your upper rear gums and cheek. It dissolves/effervesces all fizzy like which gives it a very rapid release and onset . . . 10 minutes in my case. The duration isn't very long, 1-2 hrs max, but that's all I really want from a BTP med. I was taking (same story, again) OxycodoneIR 30 mg up to 5 p/d and they would sometimes seem to "overlap" because of Oxy's long half-life. I ended up with some very nasty side effects like 3-4 hour continuous "charley-horse" cramps in my calves and feet . . . unbelievably painful. That's why I switched to the Fentora, I just couldn't see the point in taking a drug for BTP and ending up in even worse pain. I "wised up", as it were. lol

I have heard a lot of good things about Methadone for ER analgesia and you seem to be another happy camper. The only caveat that I've read in conjunction with methadone is that it has an unusually long 1/2 life that can cause problems with CNS depression when it's taken with benzos like Xanax. Your dosage would have to be way higher than the 120 mg you report so I see no cause for worry there. I'm on the 100 mcg p/h Fentanyl patch for my ER analgesic, once again, it's rather expensive. I paid full price for a month's worth so that I wouldn't have to worry about temp. shortages (you obviously know what that's like, huh?) causing dangerous interuptions in my dosage schedule . . . the price for 10 patches, one month's worth, was $490 and that's for the generic Mylan brand.

I don't know much about Opana except for the comments I've gleaned from this board. One of our posters, 3red3red, speaks very highly of it. For what it's worth, 3red3red is tops in my book . . . she is very knowledgable (35 years in the HI field!) and articulate. I'm sure she wouldn't mind if you P.M.ed her with your questions about Opana, just tell her Q sent you, she'll know who you're talking about.

You mentioned disability, do you mean SSDI? My wife and I are both successful applicants and are more than willing to help you with the process. The 1st thing is to quit lollygagging and get started on it right now! I'm not kidding either, it can take as long as 4-5 years to receive final approval so the sooner you send in that 1st application the sooner they can send you your 1st denial. Those are just the opening moves of a very long dance. I went through 2 denials and a request for hearing before I was approved. It took me 11 months in all and that's super-fast 'cause I'm terminal. That's what you're up against so get cracking on that 1st application. Also, do not get a lawyer unless you absolutely have to, you don't need one . . . we sure didn't!

One very important thing about SSDI, for some reason they really like to see clear evidence of Chronic or Clinical Depression caused by, or along with, your physical disability. Are you on anti-depressants or seeing a psychiatrist? My wife's approval took 2 1/2 years and it was granted based more on her 30 year mental history than her 15 year physical history . . . go figure. Well, sorry about the novella here, it's just that something in that "same story" thing caught my eye. I hope you find something useful in the midst of all this verbiage . . .

                                                                             Q        

Like I said, I know nothing about Methadone . . . I never even considered it's opioid agonist status. What do they Rx for BTP when a CP's ER analgesic is Methadone? My Davis's Drug Guide for Nurses 5th Ed. advises NSAIDs only for BTP when using Methadone and that "administration of partial-antagonist opioid analgesics may precipitate opioid withdrawal in physically dependent patients."  p. 763 ibid.

We definitely need edupatating on this one, Woody!   

                                                                                 Q    

Well I must chime in here.....

Rhonda- I am new to this Support Group as well and you are correct, it is wonderful to say the least!!  I have never encountered such an amazing group of individuals with such a breadth of knowledge and the kindest of hearts.

A little background:  I have been in PM since early 2002 for CRPS stemming from Muscle Compartment Syndrome, which I had a spinal cord stimulator implanted for.  I have run the gamet with pain medication for years.

Most recently I was moved to Opana ER from OxyContin ER.  I must say that the Opana ER have a dramatically different effect than the OxyContin.  I did not recieve much relief from the OxyContin at all, there were some days where I could not even tell if I had taken it.  Whereas the Opana ER walks right up and takes over the pain and tells him to take a time out (maybe hands him the cone of Silence).  I would even go as far as stating that:  If you switched over to Opana you would only need your breakthrough meds once or twice when it may have been 3 or 4 times.  It also has some longevity.  I wouldn't quite say 12 hrs but a good 7 or 8.  After one week of Opana I can say I have drunk the Kool-Aid and they work!!!!

Regards-

Patches

If you are concerned about Half Life then Hydromorphone is not the drug for you.  When you research this drug you will find out that due to presystemic metabolism the concentration of the drug is greatly reduced during the absorption process.  One of many studies reported that Hydromorphone (Dilaudid) has been reduced to 16% of its original potency when administered orally.  Hydromorphone  is a wonderful IV medication but not so much Orally.  Everyones Bio-Chemistry is different though, what works for one may not for another.

Good Luck in your search!!

Patches-

You do not have to have cancer to be prescribed Dilaudid.  At least I hope not because as I have been prescripbed Dilaudid and no one told me about any cancer .  All kidding aside I have had it before both Orally and IV.  It is a wonderful IV med great for surgery recovery after the implantation of my spinal cord stimulator.

I most recently found out how expensive Opana was thank god for my Companies Insurance plan.

Cheers

Rhonda-

My father suffers from degenerative back disease and is going back and forth with the idea of having the fusion surgery.  Should he not have it?  He lives in constant pain can not walk, sleep  or go to the bathroom, nothing.  What are your thoughts?

pose this question to your pharmicist, get her opinion on taking methadone an then oxycodone as a break-thru.

this is the only way we get knowledge, here on this forum, would love to hear their perpections on this matter, an I  inquire with mine on the 8th, an we will compare notes

got this on my mind , an gotta find out the effects just for a little more edumucation.

Woodstock

Felilks had a very detailed post about taking Methadone and oxycodone.  I thought he said Mdone had to be very high in order for the oxy not to work.  Maybe if Goat or someone who remembers exactly what was said can chime in.  My brain just is not working lately.  Take care, htmom

RIP, when you say that you can't "feel" the OxycodoneIR 30 mg that you are Rxed for BTP, do you mean that you don't "feel" the euphoria that some folks associate with opioids? I guess that you feel the analgesia since you continue to take them, what is it that you don't "feel"? This is not meant in any sort of derogatory manner, Rhonda, so please don't take me wrong. It's just that I've read a lot of posts where folks diss Fentanyl because they didn't "feel" anything. Upon further posts it has almost always turned out to be the euphoria they were missing. That's one of the great things about Fentanyl for me . . . no euphoria, no fuzz-head. Also, the Duragesic brand gives me a nasty rash too, as well as numerous other Fentanyl users. The generic Mylan brand is the patch of choice. Good luck, RIP . . . Q

Ah Q, you hit the proverbial nail on the head!  Amazing how many don't understand that the meds are to make one functionial......they are not meant to make one "feel" anything other than normal.  I guess though it explains why being a CP is so difficult......we not only have to deal with pain that never sleeps, we have to overcome the stigma associated with those that chase the ever illusive high.

In regards to the snooty pharmacist, would ask to speak with his boss, or the corparate owner of the chain, No customer is required to put up with that BS,As long as the chain store is receiving their money, the opition for pharmacist consultation is up to the consumer.

Woodstock

I can not agree more, the stigma that is now associated with pain meds is surreal.  I walked into my local pharmacist and gave him a script for endocet 10/325 and he said he was out of it for at least two weeks .  So I asked what I should do and he basically said you need to just call around until you find it, which I did.  I found it at a Pharmacy that was actually closer to my house.  I went in and told the pharmacist that I had just come from another pharmacy because he was out.  This idiot actually called over to the other pharmacy to validate my story.  I am still at a loss as to why he did that, I mean what kind of scam could I have been trying to pull.  Best part: the other Pharmacist was a Family member of mine so he validated my story and then tore him a new one about his Ethics.... I think he was beat up by the football team in school and now he is in "Somewhat" and I stress "Somewhat" of a position of power to make up for all those hallway wedgies!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

edit

I agree with you Q about the attitudes of some doctors and pharms about CP's.  I have been seeing my neurologist for years for chronic neck and low back pain.  Even though I have the MRI's to "back up" my pain, he is the type of doctor that minimizes or downright disbelieves you.  For example, when I first started seeing him, I took old MRI's with me to my appointment and he put the films up on the light box.  Although my report (which was read and dictated by my boss, also a neurologist) said that I had a herniated disc in the lumbar spine, this neurologist looked at it and called it a bulging disc instead. Also, he ordered new cervical and lumbar MRI"s at that time.  And when he read the films, his reading was completely different and minimized, compared to the prior results!

 I more recently returned to him for extreme pain in my left arm and hand.  He basically shrugged his shoulders, reluctantly gave me a RX for a whole #30 Lortab (to last a month mind you, and only after my begging for it) and sent me on my way.  It was only when my hand actually started to shrink that he believed me. It's like there has to be something that he can "see" right there in front of him before he would actually do anything.  It was only then, after the hand atrophy that he ordered cervical spine MRI and electrodiagnostic testing.  Having been a neurologic assistant for 20 years, I am in a unique position to actually have some idea what is wrong with me.  Which is definitely nerve related.  My boss agrees.  However my neurologist was of the belief that it "might" be cervical spine related.  While my cervical MRI is definitely a mess and shows what could possibly cause some radiculopathy, I don't believe it is a contributing factor.  Strangely, when my neurologist did the EMG/NCS on my left arm, he interpreted it as "normal".  At which point, my diagnosis from him was "enigma"!  Just what you want to hear from your doctor! 

I mentioned this to my boss/neurologist who then sent me to an orthopaedic surgeon for his opinion.  Ulnar neuropathy was his diagnosis (which is what my boss and I thought).  So, this orthopaedic surgeon sends me back to my boss for repeat EMG/NCS.  Apparently, he didn't agree with my neurologist's diagnosis anymore than the rest of us.  (Prior to this, although my doctor/boss has been giving his opinion, he has remained in the background, not wanting to actually "treat" me.  For some reason, he doesn't  like to have staff as patients, which I guess is his perogative.  He also doesn't want to get involved in my chronic problems, with which I agree.  However, he has gotten involved in my arm problem, partly because it is so acute, partly because I am not really getting any help from my doctor/neurologist and also, the biggest reason I think is because I am also the office transcriptionist.  This arm pain most definitely impacts upon my job!). Anyway, so my boss performs the EMG/NCS. Low and behold!  It most definitely wasn't normal. Not only did he find ulnar neuropathy at the elbow, he found ulnar neuropathy at the wrist and bilateral median nerve compressive neuropathy (carpal tunnel syndrome), which is no surprise considering I have been typing for 20 years. Very strange how two doctors can look at the same problem and come up with completely different diagnoses!

Several months ago I transferred from a mom & pop to Walgreens.  The m/p never seemed to have my medication or enough of my medication.  I loved the pharmacists there; it was hard to leave them as I had used them for many years - back to when my daughter (25) was a baby.  These 2 pharmacists treated me like a real person, perhaps because they knew me and perhaps because they had seen me walk.  In any case, I met with the new Walgreen

s pharmacy; big chain right, well trained right and surely talented and well trained pharmacists - right?  Sure they could handle anything I needed, they understood my needs and would be sure to have my meds at any time, (if not at their store, surely at another Walgreens in close proximity)......first month, no problems and excellent service (although the pharmacist I met with did not remember my name.

Second month....there is a 45 minute wait, they are backed up.....not a problem, it happens right.  I pick up my 7 scrips and write a check for $1045.26.  Get it home, put it up.  Next day, I take normal doses......for some reason, I'm extremely sleepy......next day even worse.

So the story is they doubled my MSIR's - gave me 60's instead of 30's.  I call them, how can this happen - you could have killed.  Simple mistake they say.

Bottome line, now I am with Rite Aids.  We will see how it goes.  I have yet to hear back from Walgreens.  Moral, although most pharmacists are good people, they make mistakes....we are a number to them......for CP's it could be lethal

I had things like that happen at Sav On pharmacy. One time I was shorted on a script by half, another I was given a lesser strength and the last straw before I left forever and told their corporate office, they gave me the wrong medication. I was supposed to be getting Roxicodone 15, and ended up with Morphine. Luckily I caught each time walking away before I was out of the store. I ripped the pharmacist a new one. I told him if he was too busy to do his job right than he needed to quit or get some help. For all he knew I had a special allergy to morphine. Needless to say my co pay was waived.

years ago i was filling my norco 10/325 at a sav more or sav on drug outlet. i had been filling there for like a year. then one time i got my normal refill of 120 tabs. got home and looked at the bottle and u can just feel something isnt correct, which i was right there were only 90 not 120. so i calmly called the store not demanding give me the thirty u shorted me or else, just was like could u do a count on your norco 10 bottles for the day because i only has 90 not 120. this pharm tech went into a tirade and basically told me who would not check a thing and if i didnt like it sue him. come on i know once you leave the pharmacy area it is close to nill that u will get any count corrected. i just wanted to inform that they made a mistake or someone behind their counter was diverting. last time i went there! one time at a rite aid my xanax was like 27 short or something like that, like i said when u get ur meds every month u can just tell when something doesnt feel correct, at least i can. was supposed to have 90 counted them 3 times and was 27 short so i called to let them know and i was actually surprised they told me the calibration on there dispensing machine was off for that med and told me to come down and pick the rest up with a sorry, boy i was shocked, but rite aid and cvs and some places have those automatic dispensing machines where they put the qty in and it drops into bottle deppending on what sch. drug u r getting. my worse was from a meijers a yr ago i was shorted 30 norco 10. i didnt call but they had a survey on how they are doing, what a huge mistake i filled that out, i just informed them i was short on my norco script, and this was on a survey, well like 2 weeks later i get a call from a head pharmacist at the meijer and he told me that he went thru my records and it did not look. i figured because of oxycontin and all the other stuff that they frown on i am rxd. he told me that i should transfer the rest of my refills out of there store. so what im being punished for being a victim and where they initial and circle the qty it wasnt on that bottle. whatever i got 30.00 transfer cards for all my rx i called out of there and sent to rite aid. boy i never thought i would get a call like that for doing a online survey to rate there pharmacy, i figured they hot chewed out and then they took it out on me. last time i ever do that, the pharmacist did say it did sound like they were retaliating against me for bad revue bad swore that wasnt the case. you know some meds i have to get at different stores because of the generics they carry, like my ms contins i get at walgreens for their watsons, also my norco or lorcett their because they carry watson my generic of choice. my soma i like cvs they have the dans which are watson brand. cvs carries the round xanax which arent effective for me so get those at rite aid which are the sandoz. just funny over like ten yrs of cp the stuff u go thru time to time with pharmacys. i mean jeeze if they dont know me i have my liscence out and scripts in order and am not afraid to say call my dr if u dont feel comfortable filling. poost long enuff just laughing

keep daily logs an inventories of their narcotics an controlled substances, they can do a hard count versus the the inventory

I ve seen other threads here, that request they reveiw their inventory records as their inventories are like cash in a banks till

Woodstock

It is wrong what he did, but I hope he gets help before he gets arrested and loses his career.

Hmmm, interesting, couch.  I have a patient that had a stimulator put in for a trial period and loved it. The last time he had an appt, he was between the trial and permanent placement. I haven't seen him since he had the permanent one put it. I'll have to try to remember you at his next appt and see how he is doing.

I'm sorry you are having trouble with it.  At least you are getting some relief from it.  As I said, I don't know anything about them.  Is it something like an internal TENS machine or something?  I ask because you mention being "zapped".  It has never been mentioned to me as an alternative treatment yet, but I don't think I would like it.   I know I've had that muscle stimulator thing at a chiropractor's office and have tried a TENS and for some reason, I just can't handle that electric feeling.  Weird, cause I'm not a wimp and can put up with alot, but I just can't stand that feeling.

put some back for such a problem...I always have at least a weeks worth of spare meds.